Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study

Hamano, Jun; Oishi, Ai; Morita, Tatsuya; Kizawa, Yoshiyuki

doi:10.1186/s12904-020-00543-y

Table 2 Comparison of the frequency and topics of ACP about patients being at risk of deteriorating and dying, and about patients with Palliative Performance Scale = 70 or less

From: Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study

	All patients (n = 382)		Patients at risk of deteriorating and dying^c (n = 66)		Patients not at risk of deteriorating and dying^d (n = 316)		p	Palliative performance scale = 70 or less (n = 80)		Palliative performance scale = 80 or above (n = 302)		p
	n	%	n	%	n	%	p	n	%	n	%	p
About future ADL decline
Discussed with the patient	69	18.1	19	28.8	50	15.8	0.013	17	21.3	52	17.2	0.416
Discussed with the family	28	7.3	16	24.2	12	3.8	< 0.001^a	19	23.8	9	3.0	< 0.001
Documented in medical records	46	12.0	14	21.2	32	10.1	0.012	12	15.0	34	11.3	0.439
Discussed with the patient and documented in medical records	30	7.9	6	9.1	24	7.6	0.681	2	2.5	28	9.3	0.059
Discussed with the family and documented in medical records	1	0.3	1	1.5	0	0.0	0.173^a	1	1.3	0	0.0	0.209^a
Discussed with the patient and family and documented in medical records	15	3.9	7	10.6	8	2.5	0.007^a	9	11.3	6	2.0	0.001^a
About future inability to eat
Discussed with the patient	38	9.9	10	15.2	28	8.9	0.120	6	7.5	32	10.6	0.086
Discussed with the family	14	3.7	7	10.6	7	2.2	0.004^a	7	8.8	7	2.3	0.013^a
Documented in medical records	24	6.3	5	7.6	19	6.0	0.583^a	2	2.5	22	7.3	0.130
Discussed with the patient and documented in medical records	17	4.5	3	4.5	14	4.4	1.000^a	0	0.0	17	5.6	0.29^a
Discussed with the family and documented in medical records	0	0.0	0	0.0	0	0.0	n.a	0	0.0	0	0.0	n.a
Discussed with the patient and family and documented in medical records	7	1.8	2	3.0	5	1.6	0.348^a	2	2.5	5	1.7	0.640^a
About surrogate decision makers
Discussed with the patient	32	8.4	11	16.7	21	6.6	0.008	12	15.0	20	6.6	0.023
Discussed with the family	21	5.5	12	18.2	9	2.8	< 0.001^a	15	18.8	6	2.0	< 0.001^a
Documented in medical records	24	6.3	7	10.6	17	5.4	0.157^a	9	11.3	15	5.0	0.065
Discussed with the patient and documented in medical records	10	2.6	0	0.0	10	3.2	0.222^a	0	0.0	10	3.3	0.130^a
Discussed with the family and documented in medical records	0	0.0	0	0.0	0	0.0	n.a	0	0.0	0	0.0	n.a
Discussed with the patient and family and documented in medical records	14	3.7	7	10.6	7	2.2	0.004^a	9	11.3	5	1.7	< 0.001^a
About any one ACP topic^b
Discussed with the patient	79	20.7	26	39.4	53	16.8	< 0.001	24	30.0	55	18.2	0.029
Discussed with the family	36	9.4	22	33.3	14	4.4	< 0.001	26	32.5	10	3.3	< 0.001
Documented in medical records	56	14.7	20	30.3	36	11.4	< 0.001	19	23.8	37	12.3	0.013
Discussed with the patient and documented in medical records	34	8.9	6	9.1	28	8.9	1.000	2	2.5	32	10.6	0.025
Discussed with the family and documented in medical records	1	0.3	1	1.5	0	0.0	< 0.173^a	1	1.3	0	0.0	0.209^a
Discussed with the patient and family and documented in medical records	23	6.0	13	19.7	10	3.2	< 0.001	16	20.0	7	2.3	< 0.001^a

^aFisher’s exact test
^bACP topics were; future ADL declines, future inability to eat, and surrogate decision makers
^cWith two or more general indicators or one or more clinical indicators by the SPICT-JP
^dWithout two or more general indicators or one or more clinical indicators by the SPICT-JP

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